News briefs and information from Federal agencies and Capitol Hill on government activities, legislation, and grants of interest to the telemedicine, telehealth, and health IT community. Edited by Carolyn Bloch.

Sunday, May 22, 2011

More Tests to Detect TBI

Today, the Department of Defense uses tools and tests to determine whether a service member has suffered a concussion or TBI. Mental evaluations are done if a concussion is suspected by a medic or a corpsman and then a tool called the “Military Acute Concussion Evaluation” (MACE) can be used.

The use of MACE detects concussions as early as possible and keeps service members off the battlefield where they could possible suffer another concussion before healing from the first. MACE can also confirm that a concussion didn’t occur.

Another test that DOD uses is the Glasgow Coma Scale (GCS). Even by using the GCS, mild TBI is still difficult to diagnose because many times the brain scans are negative. DOD realizes that GCS is not a very sensitive test for mild concussions, so DOD is looking at more objective tests other than studying the history and physical state of the patient. An objective test is needed that uses diagnostic markers, some of which include serum biomarkers by testing for proteins.

DOD is studying eye tracking machines that will enable devices to be placed on the eyes and pick up problems with attention and concentration which can be indicative of a concussion. In addition, DOD is also looking at machines that are capable of measuring the electrical patterns of brainwaves or quantitative EEGs to determine TBI.

Another possibility is to use vestibular plates that a patient stands on that will pick up idiosyncrasies in balance which can be indicative of changes that have happened deep in the brain stem that are consistent with concussions.

Kathy Helmick, Deputy Director for Traumatic Brain Injury at the “Defense Centers of Excellence for Psychological Health and TBI” reports that more tests are being studied but further evaluations are needed to see how well they work. Helmick reports that it probably won’t be just one test, but rather a combination of objective markers that will be able to help diagnoses mild TBI on the battlefield.

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